The celiac plexus is a cluster of nerves in the upper abdomen that carries pain signals from organs including the stomach, pancreas, liver, and bowel. Targeting it aims to reduce upper abdominal (visceral) pain, though individual results vary. Local anaesthetic is used to confirm the response; depending on your situation, longer-lasting treatment may involve a neurolytic agent (alcohol or phenol) or radiofrequency technique — your specialist will discuss which is most appropriate for you.

This procedure may help if you have:

• Upper abdominal pain related to pancreatic or other upper gastrointestinal cancer
• Chronic pancreatitis pain in selected cases
• Upper abdominal visceral pain not explained by other causes

It isn't possible to guarantee how any individual will respond. As a general guide:

• Local anaesthetic: works within minutes and wears off after a few hours — a good early sign of response.
• Neurolytic or radiofrequency treatment: when used, benefit can last weeks to several months; your specialist will discuss expected duration for your specific treatment.

This procedure is generally considered safe when performed under X-ray guidance, though as with any medical procedure the degree of benefit varies and cannot be guaranteed.

Common, minor effects:

• Temporary low blood pressure, particularly on standing, for a day or two
• Temporary diarrhoea as the bowel's nerve supply is affected
• Temporary soreness at the injection site

Rare, more serious risks:

• Infection or bleeding at the injection site
• Injury to nearby blood vessels, the kidney, lung, or bowel, which is rare with X-ray guidance
• Allergic reaction to the local anaesthetic or contrast dye
• Small increased lifetime risk from the X-ray exposure used to guide the procedure
• Serious sedation or anaesthetic complications, very rarely including stroke or death
• Rarely, weakness or altered sensation in the legs (reported with neurolytic techniques)
• Minimal or no improvement in pain

• Tell us about any blood-thinning medication (e.g. warfarin, Xarelto, Plavix) well in advance — special arrangements may be needed and you may be asked to pause these under guidance
• Tell us if you are, or might be, pregnant — this procedure uses X-ray guidance
• Tell us about any allergies, including to contrast dye, local anaesthetics, or reactions to previous injections or anaesthesia
• You will usually be asked to fast for 6 hours beforehand if sedation is planned
• Bring a list of your current medications
• Arrange for someone to drive you home afterwards

• You will lie face-down (prone) on the procedure table
• The skin over the treatment area is cleaned with antiseptic
• Local anaesthetic numbs the skin before the main needle is placed
• Live X-ray (fluoroscopy) guides the needle precisely to each target
• The procedure usually takes 30-60 minutes

• You will be monitored briefly in recovery before going home
• Some soreness at the injection sites is common for 1-3 days — simple pain relief (e.g. paracetamol) usually helps
• You may remove the small dressing after 24 hours, keeping the area clean and dry
• You may feel light-headed on standing for a day or two — stand up slowly and ask for help if needed
• Avoid strenuous activity or heavy lifting for 24-48 hours
• If you were sedated, avoid driving, operating machinery, or making important legal or financial decisions for 24 hours
• Continue your regular medications unless specifically advised otherwise

Contact your GP, Total Pain Clinic, or your nearest Emergency Department if you notice:

• Increasing redness, swelling, or discharge at the injection site
• Fever or feeling generally unwell
• New weakness, numbness, or loss of bladder/bowel control
• Severe pain not settling with simple pain relief

A review appointment is usually arranged 2-4 weeks after your procedure to discuss how you responded and plan next steps — please call Total Pain Clinic reception to schedule this if it hasn't already been arranged. Please ask your doctor any questions before you proceed; you will be asked to sign a consent form if you agree to go ahead.